Epidemiologic Reviews最新文献

Dengue fever, caused by the dengue virus (DENV) and transmitted by Aedes aegypti mosquitos, remains a global health concern with no definitive treatment. Given the challenges in vaccine development and disease management, micronutrients such as vitamin D have emerged as potential adjunctive therapies because of their immunomodulatory properties. The effectiveness of vitamin D in the prevention and control of dengue fever was assessed in this systematic review by evaluating vitamin D's impact on immune responses, viral replication, and clinical outcomes. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, relevant studies were retrieved from the PubMed, Web of Science, and Scopus databases. Inclusion criteria encompassed studies examining the association between vitamin D and DENV infection, disease severity, and immune modulation. Six studies met the inclusion criteria. Findings indicated that vitamin D supplementation reduced pro-inflammatory cytokine levels, enhanced macrophage responses, and modulated toll-like receptor activity. Higher vitamin D levels were associated with lower viral replication and milder clinical manifestations of dengue fever. Vitamin D demonstrates potential as an adjunctive therapy for dengue fever by modulating immune responses and reducing disease severity. More clinical trials are required to validate its therapeutic efficacy and determine optimal supplementation strategies. Trial registration: International Prospective Register of Systematic Review identifier: CRD42021231605.

Racial and ethnic minorities have been disproportionally burdened by hospitalization and death due to COVID-19. Participation of individuals of diverse races and ethnicities in clinical trials, according to study-level characteristics of randomized controlled trials (RCTs) that test effectiveness of COVID-19 drugs, could be insightful for future researchers. Our objective for this scoping review was to describe the frequency of race and ethnicity reported as demographic variables and specific reporting of race and ethnicity according to COVID-19 RCT characteristics. We conducted comprehensive searches in PubMed, ProQuest, World Health Organization Database, and Cochrane Central Register of Controlled Trials, and gray literature via preprint servers from January 1, 2020, to May 4, 2022. We included RCTs on emergency- or conditionally approved COVID-19 drug interventions (remdesivir, baricitinib, and molnupiravir) with or without comparators. Self-reported race as American Indian/Pacific Islander, Asian, Black/African American, or White, ethnicity as Hispanic/Latinx, study design characteristics, and participant-relevant data were collected. In total, 17 RCTs with 17 935 participants were included. Most (n = 13; 76%) reported at least 1 race and ethnicity and were US-based, industry-funded RCTs. Asian, Black, Latinx, and White participants were mostly enrolled in RCTs that studied remdesivir. Native American and Hawaiian participants were mostly assessed for progression to high-flow oxygen/noninvasive ventilation. Time to recovery was assessed predominantly in Black and White participants, whereas hospitalization or death was mostly assessed in Asian, Latinx, and multirace participants. Trialists should be aware of RCT-level factors and characteristics that may be associated with low participation of racial and ethnic minorities, which could inform evidence-based interventions to increase minority participation.

Food insecurity disproportionately affects women during their reproductive years. Food insecurity is associated with many negative health outcomes in the general population, including hypertension, diabetes, depression, anxiety, and obesity, particularly in women, yet it remains unclear whether it has negative implications for perinatal outcomes. We conducted a systematic scoping review using PubMed, Embase, and Scopus to identify studies of food insecurity and perinatal outcomes, including preterm birth, birth weight, gestational diabetes, hypertensive disorders of pregnancy, gestational weight gain, and mental health outcomes during the perinatal and immediate postpartum periods, and breastfeeding initiation. Twenty-nine studies were included. There is consistent evidence that individuals experiencing food insecurity in the prenatal period are at greater risk for depression and anxiety during pregnancy and postpartum. The findings were inconclusive for preterm delivery, birth weight, and other pregnancy outcomes, including gestational diabetes, hypertensive disorders of pregnancy, and gestational weight gain. This review highlights important data gaps related to the assessment of food insecurity in pregnancy that must be addressed to draw conclusions about potential perinatal outcomes among those experiencing food insecurity. More research is needed to understand the impacts of food insecurity on pregnancy outcomes and assess whether efforts to alleviate food insecurity improve outcomes.

This systematic review was conducted to identify effect modification and interaction factors that moderate the association between socioeconomic status (SES) and smoking behavior among adolescents. We searched the PubMed, Embase, PsycINFO, and Web of Science databases using keywords including "adolescents," "smoking," "inequality," "effect modification," and "interaction." Peer-reviewed articles published in English or French between January 1, 2011, and December 31, 2021, were included, as were relevant studies identified from reference lists. Of 3485 articles, 23 met the eligibility criteria. All reported quantitative observational study designs to identify factors that modify the SES-smoking behavior association. Two independent reviewers extracted data from each article, using a standardized form. Reporting quality was assessed using the Strengthening the Reporting of Observational Articles in Epidemiology guidelines. Of 23 studies, 13 reported statistically significant moderation associations. The most frequently studied moderators were race/ethnicity (n = 5; significant in 4) and sex (n = 5; no significant associations). Contextual factors, including school-level SES (n = 2; significant in 1), neighborhood SES (n = 2; significant in both), and peer influence (n = 2; significant in both), were also examined. Time trends (n = 2), country-level factors (n = 2), and social capital (n = 1) were significant moderators in the few studies that investigated them. Methodologically, adherence to best practices was limited. This review highlights the need for use of a wider range of SES measures, exploration of understudied potential moderators, and consistent adherence to standardized methodologies to better inform public health interventions addressing adolescent smoking inequalities.

Low socioeconomic status (SES) has been associated with an increased risk of depression and psychiatric disorders in general. In this systematic review and meta-analysis, we provide an estimate of the risk of clinical depression associated with low SES across cultures, age groups, and study designs. Finally, we tested whether associations between SES and depression differed by the income of the country in which the study was conducted. A literature search across 5 databases returned 7943 studies. Title, abstract, and full-text screening resulted in 162 included studies of which 122 were meta-analyzed, 22 were included in a cross-sectional narrative review, and 19 studies were included in a longitudinal narrative review. Meta-analyses were divided into risk estimates for composite SES, income, education, and employment. Sensitivity analyses based on differences in economic situation in the country of study origin were performed to investigate a possible source of between-study heterogeneity. Low SES was associated with an increased risk of depression across all measures of SES. Low income was associated with the highest odds ratio for depression (1.96; 95% CI, 1.53-2.52). Sensitivity analyses revealed no significant differences in between-study heterogeneity or risk of depression between high- and low-income economy groups. Comparable risks of depression across economy groups suggest that income relative to your peers, rather than absolute income, is a risk factor for depression. Preventive measures and possible policy interventions are discussed.

Gastric cancer is the fifth most common cancer and a leading cause of death worldwide. Despite a substantial body of research exploring individual food groups or dietary patterns in isolation, few studies have assessed the overall strength of the association between multiple dietary factors and gastric cancer risk. The aim for this meta-analysis was to identify the associations between dietary factors and gastric cancer risk in the Asian population. The PubMed, Web of Science, Embase, and Scopus databases were systematically searched up to December 31, 2022. Hazard ratios (HRs) with their 95% CIs were used to calculate pooled risk estimates, and Cochran's Q and I2 statistics were used to assess heterogeneity. Funnel plot and Egger's tests were used to estimate publication bias. Through stepwise screening, 30 cohort studies were deemed eligible for inclusion in this review. Results indicated a high total fruit consumption may reduce gastric cancer risk by 11% (HR = 0.89; 95% CI, 0.83-0.96), whereas high salt consumption potentially increases the risk by 97% (HR = 1.97; 95% CI, 1.34-2.90) in the Asian population. However, no associations of the other 21 food groups and 2 dietary patterns (healthy and unhealthy dietary patterns) with gastric cancer risk were found. Overall, this review demonstrates that consumption of high amounts of fruit and low amounts of salt may effectively prevent gastric cancer incidence in the Asian population. More cohort studies based on the Asian population are required to confirm the association of fish, meat, coffee consumption, and dietary pattern with gastric cancer risk.

For interventions aimed at redressing health disparities in breast cancer to be effective, a clear understanding of the nature and causes of these disparities is required. Our questions were: what is the current evidence for ethnoracial disparities in time-to-treatment initiation and survival in breast cancer, and how are the causal mechanisms of these disparities conceptualized in the literature? A comprehensive systematic search of studies on cohorts of female patients with breast cancer diagnosed with stage I-III was performed. Directed acyclic graphs were used to describe implicit causal relationships between racial/ethnic group membership and time-to-treatment initiation and survival outcomes. This review revealed strong evidence for ethnoracial disparities in both time to treatment and survival among patients with breast cancer. Unmeasured factors identified by the authors highlighted gaps in data sources and opportunities for causal reasoning. Although the existing literature describes ethnoracial disparities, there is very limited discussion of causal mechanisms and no discussion of system-level rather than individual-level effects. Addressing established ethnoracial disparities in breast cancer requires new research that explicitly considers the causal mechanisms of potential interventions, incorporating unmeasured factors contributing to these disparities. Trial registration: PROSPERO identifier: CRD42023391901.

Bloodstream infection (BSI) can be a serious complication among injured patients. Understanding the burden of injury-related BSI is important for early detection and implementing appropriate treatments to improve patient outcomes. Incidence rates and risk factors are important measures that help provide insights into the burden of injury-related BSIs and early diagnosis of patients. In this review, the aim was to comprehensively summarize incidence rates and risk factors for injury-related BSIs from scientific literature. Four electronic databases (PubMed, CINAHL [via EBSCOhost], Embase, and Web of Science) were searched. There were no limitations on the language. Studies reporting the incidence rates or risk factors associated with incidence or adverse outcomes from injury-related BSIs were included. Database searches returned 9830 articles, of which 48 were included. Incidence rates of injury-related BSIs ranged from 0.71 to 27.4 episodes per 1000 patient-days. A total of 237 potential factors associated with the development and/or outcomes of injury-related BSIs were identified and classified into 8 broad categories: demographics, prognostic scores, burn extent, clinical and patient health factors, biomarkers, resource utilization and treatments, pathogens and injuries, and mechanisms. Older age, male sex, higher injury severity score, longer length of stay, greater total body surface burn area, and inhalation injuries were the most frequently reported risk factors. This review identified a large variation in reported incidence rates but no population-based studies. Many factors have been associated with injury-related BSIs; however, the direction of association and effect sizes vary across the studies, which can be attributed to the differences in study design.